Author Topic: Surgical Approaches  (Read 2391 times)

Omaschwannoma

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Surgical Approaches
« on: October 09, 2008, 01:58:52 pm »
Hi Everyone!

Has there ever been talk here regarding better balance after one particular surgical approach? 

Why am I asking?  Well it came to me when I was responding to someone's ??'s about my recovery from surgery and the thought came to mind had I had translab approach would there be any chance of "residual" vestibular nerves left?  Hmmmmmm......
1/05 Retrosigmoid 1.5cm AN left ear, SSD
2/08 Labyrinthectomy left ear 
Dr. Patrick Antonelli Shands at University of Florida, Gainesville, FL
12/09 diagnosis of semicircular canal dehiscence right ear

ppearl214

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Re: Surgical Approaches
« Reply #1 on: October 09, 2008, 06:18:54 pm »
Hey Karen,

I took a peek at the "Balance" Forum and did see some specific to certain radio-protocols.... many may note them but mixed in threads vs. a thread name of the surgical approach and balance.

Did you try a search option for the particular procedure and "balance"? That is the only suggestion I have they may give you results you are looking.

Hope that helps.
Phyl
"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"

Omaschwannoma

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Re: Surgical Approaches
« Reply #2 on: October 10, 2008, 07:10:03 am »
Thanks Phyl, "duh!" should have done this before.  Hope I find something here. 
1/05 Retrosigmoid 1.5cm AN left ear, SSD
2/08 Labyrinthectomy left ear 
Dr. Patrick Antonelli Shands at University of Florida, Gainesville, FL
12/09 diagnosis of semicircular canal dehiscence right ear

Omaschwannoma

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Re: Surgical Approaches
« Reply #3 on: October 11, 2008, 08:25:16 am »
Did the search, but came up with nothing in particular re: better or worse balance with the three surgical approaches.  I'm just curious here more than anything. 
1/05 Retrosigmoid 1.5cm AN left ear, SSD
2/08 Labyrinthectomy left ear 
Dr. Patrick Antonelli Shands at University of Florida, Gainesville, FL
12/09 diagnosis of semicircular canal dehiscence right ear

Tumbleweed

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Re: Surgical Approaches
« Reply #4 on: October 11, 2008, 02:34:47 pm »
Hi Everyone!

... the thought came to mind had I had translab approach would there be any chance of "residual" vestibular nerves left?  Hmmmmmm......

The vestibular nerve is completely removed during translab surgery. The big question is -- in the case of someone with severe balance problems pre-surgery -- is this a good or bad thing? One theory purports that removing the balance (vestibular) nerve gives the brain a chance to compensate, thereby potentially improving balance. But I've heard stories of people having worse balance problems after their balance nerve was removed -- even many months after surgery. Perhaps they needed more time to adapt.

I would love to resolve my constant disequilibrium and would be overjoyed to learn of some solution that would effect that. But I've always considered removal of the vestibular nerve to be risky, because once it's gone it's gone for good. If removal makes balance worse, there's no going back to restore the former function (however impaired it may have been). All that said, some people have such horrible vertigo that the gamble (removing the vestibular nerve) may be worth the risk.

Best wishes,
Tumbleweed
L. AN 18x12x9 mm @ diagnosis, 11/07
21x13x11 mm @ CK treatment 7/11/08 (Drs. Chang & Gibbs, Stanford)
21x15x13 mm in 12/08 (5 months post-CK), widespread necrosis, swelling
12x9x6 mm, Nov. 2017; shrank ~78% since treatment!
W&W on stable 6mm hypoglossal tumor found 12/08

Cheryl R

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Re: Surgical Approaches
« Reply #5 on: October 11, 2008, 05:27:11 pm »
Why does it vary so among some people?         I have had mid fossa on each side so now gone on both sides and 2 translabs on the right and no vertigo or dizziness ever.       I was up walking on my day 2 days past surgery.     I have had a funny head feeling  usually outside which has improved but does occur some from time to time.           I do have balance issues and sometimes can weave with with the best of them  but have been very surprised that I did not have some of the issues which many do have.            This week is the 6 mo anniv of my last surgery.
                                           Cheryl R
Right mid fossa 11-01-01
  left tumor found 5-03,so have NF2
  trans lab for right facial nerve tumor
  with nerve graft 3-23-06
   CSF leak revision surgery 4-07-06
   left mid fossa 4-17-08
   near deaf on left before surgery
   with hearing much improved .
    Univ of Iowa for all care

leapyrtwins

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Re: Surgical Approaches
« Reply #6 on: October 11, 2008, 09:50:51 pm »
Cheryl -

6 months already?   :o  It doesn't seem possible.  Time sure flies.

You raise a very good question.  I was "room spinning" dizzy when I woke up from my surgery (retrosigmoid) and it didn't disappear very fast  :(

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

wendysig

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Re: Surgical Approaches
« Reply #7 on: October 20, 2008, 02:57:43 pm »
From what I undersrtand, if you have more dizzyness, disequalibrilum, unsteadiness, etc. before surgery, the fewer balance issues you will have after surgery because the other side has already started taking over balance/vestibular function.  It is also my understanding that leaving a damaged vestibular nerve in place sends confusing signals to the brain, which is why the vestibular nerve is cut during surgery.    I very little dizzyness had unsteadiness and some weird vision problems prior to surgery, however, my doc told me based on my ENG, he could tell I had already lost a fair amount  of balance on my right (AN) side, and my left side had already started taking over.    After surgery my balance was slightly worse than it had been, but not terrible, and is improving I still have the vision  problems but they too seem to be improving too.  I think those who have fewer balance issues before surgery are the ones who have major balance problems after surgery because their brains can't adapt quickly enough to the sudden loss.

Wendy
1.3 cm at time of diagnosis -  April 9, 2008
2 cm at time of surgery
SSD right side translabyrinthine July 25, 2008
Mt. Sinai Hospital, New York, NY
Extremely grateful for the wonderful Dr. Choe & Dr. Chen
BAHA surgery 1/5/09
Doing great!

JerseyGirl2

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Re: Surgical Approaches
« Reply #8 on: October 20, 2008, 03:50:18 pm »
I'll pose an alternate scenario to the one Wendy proposes when she says, in the previous post, that she thinks "those who have fewer balance issues before surgery are the ones who have major balance problems after surgery because their brains can't adapt quickly enough to the sudden loss" and that "if you have more dizzyness, ... etc. before surgery, the fewer balance issues you will have after surgery." I think it depends -- as so many things seem to -- on the location of the AN.

I have wracked my brain trying to recall any instance of dizziness, unsteadiness, vertigo, etc. that I may have experienced in the years prior to my AN diagnosis, and I can't come up with anything ... nor can my family. My only AN symptom was hearing loss. Further, I experienced absolutely no dizziness, etc. following my surgery (a translab procedure) -- either in the recovery room or later. I met with the physical therapist the morning after I was released to my hospital room from ICU. We spent about 15 minutes walking the halls and doing several exercises in my room and in the hallway. He said, "you don't need me," and told me to continue increasing my amount of walking and return to my regular exercise program when I felt up to it.

I'm not particularly athletic -- I've always exercised and walked a good bit and participated in dog agility (the competition in which dogs run an obstacle course) for about four years several years ago, but have never run nor played tennis, etc. I've assumed that my AN steadily and slowly affected my balance, just as it did my hearing, over a course of years ... and my brain and non-AN side vestibular nerve had ample time to adjust ... and I never even noticed.

 I'm also assuming that this must happen at least fairly often -- none of my doctors nor the therapist gave me the impression that my lack of dizziness and unsteadiness was remotely unusual.  I'm thinking that a lot of patients who don't experience balance or vision issues simply aren't posting on this forum.

Catherine (JerseyGirl2)

Translab surgery and BAHA implant: House Ear Institute, Los Angeles, 1/2008
Drs. J. House, Schwartz, Wilkinson, and Stefan
BAHA Intenso, 6/2008
no facial, balance, or vision problems either before or after surgery ... just hearing loss
Monmouth County, NJ

Soundy

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Re: Surgical Approaches
« Reply #9 on: October 20, 2008, 09:39:54 pm »
Pre-surgery I had some dizziness that for lack of better description came in waves...

Really dizzy and over 2 or 3 weeks would settle down to mildly annoying and then build back over
several weeks to very dizzy again... it ran in these cycles over and over...

since surgery I am dizzy on a daily basis ...mornings and late evenings are worst ...after several hours
up I am better but balance deteriorates as the days wears on...

Wide open spaces really bring on wonky headedness... I walk looking down if there is nothing
nearby to touch... in the halls at school I drag my hand against wall...don't have to hold on ...just the
touch is enough to keep me from feeling too tipsy and keeps me headed in the right direction

We went through Cathedral Caverns in Alabama Thursday and between the darkness and uneven
ground I was wobbling to the point of getting stares and comments were made about drugs and booze
by some of the people in the group we went through with... I hung to the back going in and coming out...
I was there back in the spring and luckily got the same guide and he walked along side me coming out with
his Mag Lite making me a little puddle of light to follow out ... he offered to have the golf cart brought
in to get me but I refused and wobbled out under my own powers and glared at some rude people...

part of me wants to wear a shirt saying I Survived Brain Surgery ...What's Your Excuse or something
and the other part is getting to the point I figure it is no ones business and doesn't want to explain

I think I will quit cause I am wondering off topic
3mm AN discovered Aug 2004
Translab July 2 ,2007
3.2cm x 2.75cm x 3.3cm @ time of surgery